Health Economics in Pediatric Orthopaedic Surgery

Abstract

Healthcare expenditures in the United States continue to rise without corresponding improvements in outcomes. Because of this, there is increasing pressure on physicians to consider the economic impacts of their medical decisions. Unfortunately, physicians in general are unfamiliar with interpreting and performing various health economic analyses. A basic understanding of health economics may help physicians understand and participate in key policy discussions which may shape the future of medicine and surgery.

 In the field of pediatric orthopaedics specifically, the literature involving health economic evaluation is sparse. This may be due to a combination of unfamiliarity with the topic and also difficulties with applying economic evaluation methods to the pediatric population. However, many interventions in this field are low cost with many potential benefits that accrue over a child’s long lifespan. Economic evaluation can help objectively quantify the impact of these interventions, as well as bolster responsible medical decision-making.

To that end, the purpose of the current review is to introduce the pediatric orthopaedic community to commonly utilized healthcare economic tools including cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis with a focus on several key concepts including value, quality, time, cost, and discounting. To help illustrate these concepts, health economic literature relevant to pediatric orthopaedics is discussed. Finally, we highlight limitations inherent to health economic evaluations in general and those applicable to pediatric orthopaedics specifically. This discussion may help lay the groundwork for future studies and for further involvement in policy-making.